摘要
目的 探讨在老年糖尿病患者中开展尿白蛋白、免疫球蛋白G(IgG)、β2 微球蛋白检验的应用价值.方法 选择济南市中西医结合医院 2023 年 1 月—2024 年 1 月收治的 120 例老年 2 型糖尿病患者作为研究对象,根据患者是否合并糖尿病肾病分为糖尿病肾病组(31 例)和单纯糖尿病组(89 例);另外选择该院同期 100 例健康体检者纳入健康对照组.采集各组受检者的尿液和血液标本进行生化检验,采用尿液分析仪检测尿白蛋白、尿IgG,采用β2 微球蛋白检测试剂盒测定血清β2 微球蛋白.比较各组受检者上述指标水平差异.采用Spearman相关性分析法,分析尿白蛋白、尿IgG、血清β2微球蛋白与糖尿病肾病发生的相关性;比较尿白蛋白、尿IgG、血清β2 微球蛋白单独与联合检测对糖尿病肾病的诊断结果.结果 糖尿病肾病组的尿白蛋白、尿IgG、血清β2 微球蛋白水平均显著高于单纯糖尿病组和健康对照组[尿白蛋白(mg/L):41.57±9.20 比 29.03±5.62、18.74±2.95;尿IgG(mg/L):174.57±25.60 比 146.43±20.17、103.05±14.29;血清β2 微球蛋白(mg/L):3.78±0.96 比 2.09±0.54、1.40±0.36;均P＜0.05],且单纯糖尿病组的尿白蛋白、尿IgG、血清β2微球蛋白水平均显著高于健康对照组(均P＜0.05).尿白蛋白、尿IgG、血清β2微球蛋白与糖尿病肾病的发生均呈正相关(r值分别为 0.854、0.832、0.879,P值分别为 0.003、0.004、0.002).尿白蛋白、尿IgG、血清β2 微球蛋白联合检测诊断糖尿病肾病的敏感度和阴性预测值分别为 96.77%、98.82%,均显著高于各项指标单一检测,而联合检测的特异度、准确度、阳性预测值分别为94.38%、95.00%、85.71%,与单一检测比较差异均无统计学意义.结论 尿白蛋白、尿IgG、血清β2 微球蛋白水平在老年2 型糖尿病患者中普遍升高,尤其是在糖尿病肾病患者中升高更明显,各指标联合检测对糖尿病肾病具有较高的诊断价值.
Abstract
Objective To explore the application value of urinary albumin,immunoglobulin G(IgG)and β2 microglobulin detection in elderly diabetic patients.Methods The 120 elderly patients with type 2 diabetes admitted to Jinan Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to January 2024 were selected as research objects.According to whether the patients had diabetes nephropathy,they were divided into diabetes nephropathy group(31 cases)and simple diabetes group(89 cases).In addition,100 healthy individuals who underwent physical examinations in the same period of the hospital were selected as control group.The urine and blood samples from each group were collected for biochemical testing,the urine analyzer was used to detect urinary albumin and IgG,and the β2 microglobulin assay kit was used to detect serum β2 microglobulin.The differences in the levels of above indicators among each group were compared.Spearman correlation analysis was used to analyze the correlation between urinary albumin,urinary IgG,serum β2 microglobulin and diabetes nephropathy.The diagnostic results of urinary albumin,urinary IgG and serum β2 microglobulin for diabetes nephropathy were compared.Results The levels of urinary albumin,urinary IgG and serum β2 microglobulin in diabetes nephropathy group were significantly higher than those in simple diabetes group and control group[urinary albumin(mg/L):41.57±9.20 vs.29.03±5.62,18.74±2.95;urinary IgG(mg/L):174.57±25.60 vs.146.43±20.17,103.05±14.29;serum β2 microglobulin(mg/L):3.78±0.96 vs.2.09±0.54,1.40±0.36;all P＜0.05],and the levels of urinary albumin,urinary IgG and serum β2 microglobulin in simple diabetes group were significantly higher than those in control group(all P＜0.05).Urinary albumin,urinary IgG,and serum β2 microglobulin were positively correlated with the occurrence of diabetes nephropathy(r values were 0.854,0.832 and 0.879,P values were 0.003,0.004 and 0.002).The sensitivity and negative predictive value of combined detection of urinary albumin,urinary IgG and serum β2 microglobulin in the diagnosis of diabetes nephropathy were 96.77%and 98.82%,respectively,which were significantly higher than those of single detection of each index.However,the specificity,accuracy and positive predictive value of combined detection were 94.38%,95.00%and 85.71%,and there was no statistical difference between combined and single detection.Conclusions The levels of urine albumin,urinary IgG and serum β2 microglobulin are generally increased in elderly patients with type 2 diabetes,especially in patients with diabetic nephropathy,which is more obvious.Combined detection of different indicators has good diagnostic value for diabetic nephropathy.
维普
万方数据